Director, Provider Contracting
成为我们关心社区的一部分 提供商承包主任为医疗保险机构创办，谈判和执行医生，医院或其他供应商合同和协议。提供商承约主管需要深入了解组织的能力在整个功能或细分层中如何相互相关。提供商委会主任向提供商传达合同条款，支付结构和退还率。分析合同和条款的财务影响。保持合同和文档在跟踪系统内。根据网络构成和需求，可以帮助识别和招聘提供商。决策通常与新/更新的项目或大型项目的实施有关，支持技术/运营程序和流程，并执行战略计划，推动目标和目标，提高性能。为功能战略提供输入。使用你的技能来产生影响所需资格 · 业务，金融或相关领域学士学位；或者至少10年的供应商承包经验包括医院和基于价值的承包工作 · 具有医院和基于价值的合同工作经验至少5年；• 有领导人员或项目经验；• 拥有强大的财务敏，能够分析和解释供应商合约领域的金融趋势；• 具备证明的合同准备和谈判技能，有深入了解医疗保险合同工作，包括基于价值/激励合同的工作经验。· 在东北地区 (MD,DC,DE,PA,NJ,NY,CT,MA,ME,NH,VT,RI) 居住；工作在家里要求：为了确保家庭或混合家庭/办公室员工能有效地工作，家庭或混合住宅/办公厅员工的自动提供互联网服务必须满足以下标准：至少需要下载速度为25Mbps 和上传速度为10 Mbps;建议连接无线电缆或 DSL. 在某些角色中，最低推的无线网络速度是：
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The Director, Provider Contracting initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Director, Provider Contracting requires an in-depth understanding of how organization capabilities interrelate across the function or segment.The Director, Provider Contracting communicates contract terms, payment structures, and reimbursement rates to providers. Analyzes financial impact of contracts and terms. Maintains contracts and documentation within a tracking system. May assist with identifying and recruiting providers based on network composition and needs. Decisions are typically related to the implementation of new/updated programs or large-scale projects for the function and supporting technical/operational procedures and processes, and implements strategic plans, drives goals and objectives, and improves performance. Provides input into functions strategy.
Use your skills to make an impact
Required Qualifications
- Bachelor’s Degree in Business, Finance or a related field; or a minimum of 10 years’ provider contracting experience to include hospital and value-based contracting
- A minimum of 5 years contracting experience to include hospital and value-based contracting
- Experience leading people or projects
- Strong financial acumen with proficiency in analyzing and interpreting financial trends in the provider contracting arena
- Proven contract preparation and negotiation skills, with an in-depth knowledge of Medicare contracting including Value Based/ Incentive contracting experience.)
- Must live within the Northeast Region (MD, DC, DE, PA, NJ, NY, CT, MA, ME, NH, VT, RI)
Preferred Qualifications
- Master’s degree in business administration or finance
- Experience with ACO/Risk Contracting
Additional Information
This role is "remote/work at home", however, you must live within the
Northeast Region (MD, DC, DE, PA, NJ, NY, CT, MA, ME, NH, VT, RI) to be considered for this opportunity.
Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.Scheduled Weekly Hours
40Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$138,900 - $191,000 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Originally posted on Himalayas